UP Manila point of care devices help detect pharmaceuticals and designer drugs in poisoning cases

By Andre DP Encarnacion on August 12, 2024

A team of researchers from the University of the Philippines (UP) Manila recently unveiled the E-Tox Point of Care Testing (POCT) device that aims to address gaps in toxicology testing in the country. This device comes in two models: E-Tox-NPS, designed to detect New Psychoactive Substances (NPS) such as ketamine, synthetic cannabinoids, and synthetic cathinones; and E-Tox-PHX, which focuses on detecting pharmaceuticals such as paracetamol, isoniazid, and salicylate poisoning.

"Globally, acute poisoning with pharmaceuticals is a public health problem," said Ailyn M. Yabes, MScPH, DrPH, principal investigator and Associate Professor at the Department of Pharmacology and Toxicology, College of Medicine, as she explained the urgent need for such a device in the Philippines. "The World Drug Report estimates pharmaceutical poisoning accounting for an estimated 190,000 annual fatalities worldwide and the prevalence of non-fatal poisoning being 20-30 times higher."

Pharmaceuticals, she explained, account for the largest percentage of inpatient referrals, citing data from the UP-PGH National Poison Management and Control Center (NPMCC). She identified paracetamol as a major source of accidental and deliberate poisoning, which has led to major issues not just in the country but in the region.

In her presentation, Yabes cited the case of a 22-year-old female patient who overdosed on paracetamol and whose diagnosis and management were delayed. This, she said, could have been avoided if there had been a point-of-care device in the emergency room. Furthermore, although signs and symptoms can, indeed, help towards a differential diagnosis, "having a diagnostic test that would indicate the presence of a certain pharmaceutical or a certain drug would definitely aid in either ruling in or ruling out the offending agent," Yabes said.

Likewise, the United Nations Office for Drugs and Crime (UNODC) defines NPS as substances of abuse not under the 1961 Convention on Narcotic Drugs or the 1971 Convention on Psychoactive Substances, but which may pose a public health threat. These drugs mimic the effects of illicit drugs like cannabis, cocaine, ecstasy, and LSD.

Yabes said that current drugs of abuse (DOA) test kits in the Philippines do not include NPS, and that existing lab-based testing platforms for them and pharmaceuticals are often costly and require harmful chemicals that make them impractical for emergency or bedside toxicology testing. There is a need, therefore, for a portable, user-friendly, and cost-effective point-of-care testing device in emergency settings.

Joining Yabes in the development of the device were: Prof. Noel Quiming, Department of Physical Sciences and Mathematics, UP Manila CAS as Co-Investigator; Asst. Prof. Sarah Johnson, Department of Physical Sciences and Mathematics, CAS, UP Manila as Co-Investigator; Gabrielle Pagjunasan, University Researcher I, UP Manila; Greg Andrew Octa, University Researcher I, UP Manila; and Jessa Turreda, University Research Associate, UP Manila, as Project Staff.

Both the E-Tox-NPS and the E-Tox-PHX have undergone validation and demonstrated acceptable performance characteristics in terms of limit of detection, accuracy, precision, sensitivity, specificity, and predictive values as per UNODC, CLSI, and ISO 5725-1:2023 standards.

Read the original UP Manila report here.